INTRODUCTION AND OBJECTIVES: The novel biomarker ST2 provides diagnostic information in a variety of clinical settings. The objective was to determine whether measurement of the soluble ST2 (sST2) concentration improves risk stratification in outpatients with decompensated heart failure (HF). METHODS: The concentrations of sST2 and N-terminal probrain natriuretic peptide (NT-proBNP) and a heart failure severity score (HFSS), based on Framingham criteria, were determined at baseline and 2 weeks later in 48 outpatients with decompensated hf. The ratio of the value of each variable at week 2 relative to baseline was determined. Patients were followed for 1 year and cardiac events (i.e. death, HF admission and heart transplantation) were recorded. RESULTS: By 1 year, 56% of patients had experienced a cardiac event. The sST2 ratio was significantly lower in patients who did not have a cardiac event (0.6 ± 0.39 vs. 1.39 ± 0.92; P< .001). After multivariable adjustment, the sST2 ratio remained an independent predictor of risk (odds ratio=1.054; 95% confidence interval, 1.01-1.09; P=.017). The optimum cut-point for the sST2 ratio determined by receiver operating curve [ROC] analysis was 0.75; this accounted for 25% of the change in sST2 by week 2. Among patients with an sST2 ratio >0.75 and a baseline NT-proBNP level >1000 ng/L, 72% had a cardiac event (P=.018), while no events occurred in patients with marker values below these reference levels. CONCLUSIONS: Determination of the sST2 concentration in serial samples provided additional risk stratification in outpatients with decompensated HF. Repeated measurement of sST2 may aid clinical decision-making.
INTRODUCTION AND OBJECTIVES: The novel biomarker ST2 provides diagnostic information in a variety of clinical settings. The objective was to determine whether measurement of the soluble ST2 (sST2) concentration improves risk stratification in outpatients with decompensated heart failure (HF). METHODS: The concentrations of sST2 and N-terminal probrain natriuretic peptide (NT-proBNP) and a heart failure severity score (HFSS), based on Framingham criteria, were determined at baseline and 2 weeks later in 48 outpatients with decompensated hf. The ratio of the value of each variable at week 2 relative to baseline was determined. Patients were followed for 1 year and cardiac events (i.e. death, HF admission and heart transplantation) were recorded. RESULTS: By 1 year, 56% of patients had experienced a cardiac event. The sST2 ratio was significantly lower in patients who did not have a cardiac event (0.6 ± 0.39 vs. 1.39 ± 0.92; P< .001). After multivariable adjustment, the sST2 ratio remained an independent predictor of risk (odds ratio=1.054; 95% confidence interval, 1.01-1.09; P=.017). The optimum cut-point for the sST2 ratio determined by receiver operating curve [ROC] analysis was 0.75; this accounted for 25% of the change in sST2 by week 2. Among patients with an sST2 ratio >0.75 and a baseline NT-proBNP level >1000 ng/L, 72% had a cardiac event (P=.018), while no events occurred in patients with marker values below these reference levels. CONCLUSIONS: Determination of the sST2 concentration in serial samples provided additional risk stratification in outpatients with decompensated HF. Repeated measurement of sST2 may aid clinical decision-making.
Authors: Marat Fudim; Jacob P Kelly; Aaron D Jones; Omar F AbouEzzeddine; Andrew P Ambrosy; Stephen J Greene; Yogesh N V Reddy; Kevin J Anstrom; Brooke Alhanti; Gregory D Lewis; Adrian F Hernandez; G Michael Felker Journal: Am Heart J Date: 2019-11-16 Impact factor: 4.749
Authors: Jonathan Beaudoin; Jagmeet P Singh; Jackie Szymonifka; Qing Zhou; Robert A Levine; James L Januzzi; Quynh A Truong Journal: Can J Cardiol Date: 2016-06-02 Impact factor: 5.223
Authors: Erin E Coglianese; Martin G Larson; Ramachandran S Vasan; Jennifer E Ho; Anahita Ghorbani; Elizabeth L McCabe; Susan Cheng; Michael G Fradley; Dana Kretschman; Wei Gao; George O'Connor; Thomas J Wang; James L Januzzi Journal: Clin Chem Date: 2012-10-11 Impact factor: 8.327